Christiana Care has enteredinto a partnership with a health plan that makes a commitmentto meeting measurable health goals for Medicaid-eligible Delawareans.
Instead of being paid for individual tests, procedures and visits, providers like Christiana Care will see their compensation tied more directly to health outcomes.
AmeriHealth Caritas Delaware administers care for more than 50,000 Delaware residents on Medicaid, a health insurance program for low-income residents.
Christiana Care will provide health care services for the Medicaid members whose health AmeriHealth has agreed to manage.
This deal hasmeasurable performance goals in seven areas identified as key opportunities to save costs and improve quality. They are:
- Diabetes care.Although the condition is incurable, health care to manage diabetes can prevent complications. The goal is for patients to be below 8 percent on a test that reflects blood sugar levels.
- Medication management for people with asthma.Medication can reduce the need for rescue inhalers and cut down on hospital visits, but studies have found that up to 60 percent of children don’t take their daily asthma medication. The goal is for patients to be on their asthma medications at least three-fourths of the time.
- Cervical cancer screening.Once the most common cause of cancer death for American women, cervical cancer death rates declined by more than 60 percent in the second half of the 20thcentury. That was largely thanks to the Pap smear, which can identify abnormalities before they turn cancerous. The goal is to improve access to cervical cancer screening.
- Breast cancer screening.Mammograms can catch breast cancer at an earlier stage, when treatments are more effective. This quality measure rates providers on how many of their patients have regular screening.
- Body-mass index assessments.Obesity is a factor in an estimated one in five deaths in America. This quality measurement looks at what percentage of adults had their body-mass index — a ratio of a person’s height to their weight — documented in the current or previous years.
- Prenatal and postpartum care.Medical care early in a pregnancy is a crucial part of a healthy pregnancy and birth. This quality measurement also documents what percentage of women had a postpartum visit between 21 and 56 days after delivery.
- 30-day hospital readmission rates.The percentage of patients who return to the hospital within 30 days of leaving one is often used to measure the hospital’s quality.
“Paying for value caters to our institutional strengths, as efficient care is a core part of the Christiana Care Way,” said Barry Dahllof Jr., vice president ofEnterprise Contracting and Payor Relations at Christiana Care. “Thousands of people in Delaware are affected by the health issues that we aim to address through this initiative, and we’re confident in our ability to meet these standards because our health care teams already have a deep commitment to providing value-based care.”
The partnership, which was signed in June and retroactive to January 2018, begins with a data collection period so Christiana Care, AmeriHealth Caritas and the State of Delaware can develop a baseline in measuring improvements.
Christiana Care has a network of outpatient services, home health care, medical aid units, two hospitals (1,227 beds), a Level I trauma center and a Level III neonatal intensive care unit, comprehensive stroke center and regional centers in cardiology, cancer and women’s health. Christiana Care is also a not-for-profit teaching health system with more than 260 residents and fellows.
AmeriHealth Caritas is part of the Independence Health Group, Philadelphia, in partnership with Blue Cross Blue Shield of Michigan. Operating in 15 states and the District of Columbia, AmeriHealth Caritas serves approximately 5.3 million Medicaid, Medicare and Children’s Health Insurance Program (CHIP) members For more information, visitwww.amerihealthcaritas.com.